By CATHERINE MASTERS
Weary after 12 hours of piecing together a tiny face, plastic surgeon Janek Januszkiewicz is also furious.
He is furious at the "cowardly and compassionless" missing owner of the dog that attacked 7-year-old Carolina Anderson in a park in Westmere, Auckland, leaving half her face missing, bone exposed,
her right eye at serious risk of being forever useless, and needing skin grafts and painstaking microsurgery.
He is furious at a society that cannot make up its mind about how it lives with animals, one that allows weak penalties that do not send clear messages of consequences to irresponsible dog owners.
Treating dog-bite victims at Middlemore and Kidz First hospitals rolls around with relentless and depressing repetitiveness.
It is a worldwide problem.
"In the States, because there's been little action from state and federal government, plastic surgeons took the initiative and have campaigned for dog bite awareness weeks and I think there are similar sorts of initiatives in Australia," he said.
Here there was ignorance at the extent of the problem, he said. Owners of dogs that attacked might eventually be taken to court and often pleaded for leniency.
The dog that savaged the little girl was a dangerous one that must be destroyed, but destroying one dog was irrelevant to the bigger picture.
"The owner needs to be punished in a way that sends out a clear signal that if people aren't responsible with their animals, keeping them restrained in public, if people aren't responsible for the behaviour of their pets then they will pay the price," Mr Januszkiewicz said.
"I think that society has a responsibility to decide whether it will tolerate this sort of behaviour from animals in the community and if it's unacceptable society needs to decide how it's going to deal with it.
"Or we can just say that it's acceptable, we tolerate it, it's one of the risks of having animals living with us and therefore it's just tough luck for this girl. I don't think many people can take that attitude."
Mr Januszkiewicz is also angry at the resourcing of the health system and accuses the Government of playing with waiting-list figures to make it look better.
Carolina's dramatic admission to hospital has a much wider context.
When she arrived in theatre at 8am on Saturday she ended up requiring 12 hours of surgery. Twenty other acute patients who were on the list had to be moved back.
"Some of those had been waiting three or four days with open fractures and compound injuries that medically should be treated within six hours of injury - they had been waiting three or four days," he said.
"Some of those people are still waiting because the resources provided for in the public sector and particularly at South Auckland [District] Health [Board] are inadequate to cope with the demand.
"It's not because we did her that everything else goes on hold. She's yet another person who joins the queue, gets done urgently, but the amount of water being poured into the bucket is much, much more than what can drain out the other end."
A consequence was poorer results for the people who had been waiting for days not being allowed to eat because they were waiting for an operation.
When they were eventually seen, crucial time had elapsed and infection risks increased.
"I've got several people this weekend who we've treated, we've had to use methods of treatment that were far less than ideal and will have results that are not as good as they should have been because they had to wait." Eventually, surgeons would try to catch up with the plastic surgery acute list, Mr Januszkiewicz said. But this would be done by cancelling a lot of people needing elective surgery.
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